Neural Mechanisms Underlying the Antidepressant Effects of Sleep Deprivation

From 40 to 60% of patients with depression experience a rapid and significant improvement of
mood with one night of sleep deprivation (SD). The neural mechanisms underlying this effect
have not been elucidated. Recent advances in functional neuroimaging have provided new
opportunities to investigate state changes in regional brain function, along with a better
understanding of the neural networks affected by depression and SD. Here we propose to study
a group of N=48 antidepressant-free male and female patients with current depression symptom
and N=12 healthy controls with no history of mood disorders before and after SD to provide
mechanistic insight into the neural substrates underlying the antidepressant effects of SD.
We hypothesize that SD-induced concurrent functional activity and connectivity changes in
multiple brain networks related to different depressive symptom dimensions including emotion
regulation, attention, arousal, self-referential, and reward processing will underlie the
rapid and transient antidepressant effects of SD. Using an ABA design, multimodal brain
imaging along with more traditional electroencephalographic (EEG) and neurobehavioral testing
data will be acquired at baseline after normal sleep, during one night of total SD, and after
one night of recovery sleep using a 5-day in laboratory protocol during which subjects will
be continuously monitored by trained staff.